This document discusses female hair transplant, including:
1. The most common causes of hair loss in women are androgenetic alopecia and alopecia areata. Indications for hair transplant in women include female pattern hair loss, traction alopecia, and post-traumatic hair loss.
2. Female pattern hair loss is a gradual, progressive thinning that typically begins after age 40. It results from a reduction in the anagen phase of the hair cycle. Three patterns of female pattern hair loss are described.
3. Candidates for hair transplant need significant thinning, a compliant with continued medical treatment, a good donor area, and realistic expectations. Results take longer for women due to technical challenges
Hair loss in females may be due to various reasons, the role of genetics, hormones, and nutrition are important in pathogenesis. FPHL - female pattern hair loss is the term used to describe hair loss in females. Thorough investigation are required to know underlying causes. Topical Minoxidil application is the only USFDA approved treatment. Treatment of underlying causes such as PCOS, thyroid disorder, and iron deficiency has to be done.
Hair loss in females may be due to various reasons, the role of genetics, hormones, and nutrition are important in pathogenesis. FPHL - female pattern hair loss is the term used to describe hair loss in females. Thorough investigation are required to know underlying causes. Topical Minoxidil application is the only USFDA approved treatment. Treatment of underlying causes such as PCOS, thyroid disorder, and iron deficiency has to be done.
Approach to a case of diffuse hair loss in females
. Anagen effluvium-
(a)Dystrophic
(b)Loose anagen hair
2. Telogen effluvium –
(a)acute telogen effluvium
(b)Chronic telogen effluvium
3. Female pattern hair loss
Primary CTE –represents a primary disorder and is a diagnosis of exclusion.
Secondary CTE- secondary to variety of systemic disorders.
Iron deficiency
Other deficiency –protein calorie malnutrition ,zinc deficiency
Thyroid diseases
Metabolic diseases-chronic liver or renal failure, advanced malignancy, pancreatic disease and upper GI disorder with malabsorption
SLE and other connective tissue disorders.
HIV infection
Drug induced
Hair shortfall is very general in both men along with girls. You or an important person you love could be experiencing hair thinning.
Learning about standard hair growth is especially valuable in understanding balding.
This reference review will support you comprehend alopecia, the various types of balding, and their
remedy choices.
Lecture by Dr. Patrick Treacy from Ailesbury Hair Clinics to ICAD 2014 Brazil on the reasons and treatments for female hair loss. Courtesy given at lecture to some other doctors and clinics for some images used. Images related to Ailesbury Hair Clinics were added at a alter time.
Hair diseases are disorders primarily associated with the follicles of the hair. Many hair diseases can be associated with distinct underlying disorders. Hair disease may refer to excessive shedding or baldness (or both). Balding can be localized or diffuse, scarring or non-scarring.
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Androgenetic alopecia (AGA) is a nonscarring progressive miniaturization of the hair follicle in genetically predisposed men and women, usually in a specific pattern distribution.
Multifactorial and polygenetic etiology.
Clinical features:
-History of hair loss is -
long standing
slowly progressing reduction of hair density, diameter
Miniaturization of hair
Diminished anagen hair and increased telogen hair
-Pattern of hair loss in male:
Hamilton- Norwood type: recession of frontal hair line, latter followed by a vertex thinning with progression until top of the scalp is completely bald.
-Pattern of hair loss in female:
Centrofrontal hair loss with preservation of frontal hair line
(Ludwig type) {figure - left}
Christmas tree pattern {figure- right}
-Family history of AGA often positive
In female
signs of hyperandrogenism should be evaluated
gynecological history
progesterone containing pills
-To exclude other causes history should be taken regarding-
Thyroid disease,
Surgery, infection in last 6months to 1 year
Drug history
Iron deficiency
Smoking
UV exposure
Hair color, cosmetics use.
Allergic contact dermatitis
Treatment:
Androgenic alopecia is naturally progressive , so main strategy is to prevent progression and increase hair density.
1.Topical minoxidil:
2% for female and 5% spray for male 1 ml twice daily or half cup foam once daily.
There is transitory telogen shedding within first 8 weeks observed.
Response should be assessed after 6 months.
If response occurs, will be continued as main stay of treatment.
2.Finasteride oral ad Dutasteride oral
1 mg finasteride per day prevents progression of AGA .
0.5 mg daily dutasteride is alternative.
Combination of topical minoxidil and finasteride is good option
Response evaluated after 6 months . not indicated in women. Contraindicated in pregnant and child bearing female.
3.Antiandrogen and estrogenic drugs:
Given in hyperandrogenism in female. Not indicated in male.
Spironolactone 100-200 mg daily
Cyproterone acetate can be used
4.Hair transplantation
5.Low-level laser therapy
6.Miscellaneous: low level of evidence.
Platelet rich plasma therapy and microneedling
Herbal preparations
Topical melatonin
Nutritional supplement of- biotin, copper, zinc, aminoacids, micronutrients
This is my very first power point. I made it for my Human Anatomy class. There is not any special features because we only had to turn in hard copies. This was a really easy and entertaining assignment!
Approach to a case of diffuse hair loss in females
. Anagen effluvium-
(a)Dystrophic
(b)Loose anagen hair
2. Telogen effluvium –
(a)acute telogen effluvium
(b)Chronic telogen effluvium
3. Female pattern hair loss
Primary CTE –represents a primary disorder and is a diagnosis of exclusion.
Secondary CTE- secondary to variety of systemic disorders.
Iron deficiency
Other deficiency –protein calorie malnutrition ,zinc deficiency
Thyroid diseases
Metabolic diseases-chronic liver or renal failure, advanced malignancy, pancreatic disease and upper GI disorder with malabsorption
SLE and other connective tissue disorders.
HIV infection
Drug induced
Hair shortfall is very general in both men along with girls. You or an important person you love could be experiencing hair thinning.
Learning about standard hair growth is especially valuable in understanding balding.
This reference review will support you comprehend alopecia, the various types of balding, and their
remedy choices.
Lecture by Dr. Patrick Treacy from Ailesbury Hair Clinics to ICAD 2014 Brazil on the reasons and treatments for female hair loss. Courtesy given at lecture to some other doctors and clinics for some images used. Images related to Ailesbury Hair Clinics were added at a alter time.
Hair diseases are disorders primarily associated with the follicles of the hair. Many hair diseases can be associated with distinct underlying disorders. Hair disease may refer to excessive shedding or baldness (or both). Balding can be localized or diffuse, scarring or non-scarring.
Looking for Cosmetologist in Andheri West, Mumbai? Dr. Priyankas Cosmoshine specialize in Hair Transplant and Cosmetic Surgery & Expert Dermatological care
Dr. Eric Holzer has earned international recognition from thousands of satisfied patients in his Manhattan, California and Arizona Hair Restoration Practices, Hair loss treatments for men & women at very lower prices. For more info Visit at http://www.erhhairrestoration.com/hair-loss-treatments.html.
Androgenetic alopecia (AGA) is a nonscarring progressive miniaturization of the hair follicle in genetically predisposed men and women, usually in a specific pattern distribution.
Multifactorial and polygenetic etiology.
Clinical features:
-History of hair loss is -
long standing
slowly progressing reduction of hair density, diameter
Miniaturization of hair
Diminished anagen hair and increased telogen hair
-Pattern of hair loss in male:
Hamilton- Norwood type: recession of frontal hair line, latter followed by a vertex thinning with progression until top of the scalp is completely bald.
-Pattern of hair loss in female:
Centrofrontal hair loss with preservation of frontal hair line
(Ludwig type) {figure - left}
Christmas tree pattern {figure- right}
-Family history of AGA often positive
In female
signs of hyperandrogenism should be evaluated
gynecological history
progesterone containing pills
-To exclude other causes history should be taken regarding-
Thyroid disease,
Surgery, infection in last 6months to 1 year
Drug history
Iron deficiency
Smoking
UV exposure
Hair color, cosmetics use.
Allergic contact dermatitis
Treatment:
Androgenic alopecia is naturally progressive , so main strategy is to prevent progression and increase hair density.
1.Topical minoxidil:
2% for female and 5% spray for male 1 ml twice daily or half cup foam once daily.
There is transitory telogen shedding within first 8 weeks observed.
Response should be assessed after 6 months.
If response occurs, will be continued as main stay of treatment.
2.Finasteride oral ad Dutasteride oral
1 mg finasteride per day prevents progression of AGA .
0.5 mg daily dutasteride is alternative.
Combination of topical minoxidil and finasteride is good option
Response evaluated after 6 months . not indicated in women. Contraindicated in pregnant and child bearing female.
3.Antiandrogen and estrogenic drugs:
Given in hyperandrogenism in female. Not indicated in male.
Spironolactone 100-200 mg daily
Cyproterone acetate can be used
4.Hair transplantation
5.Low-level laser therapy
6.Miscellaneous: low level of evidence.
Platelet rich plasma therapy and microneedling
Herbal preparations
Topical melatonin
Nutritional supplement of- biotin, copper, zinc, aminoacids, micronutrients
This is my very first power point. I made it for my Human Anatomy class. There is not any special features because we only had to turn in hard copies. This was a really easy and entertaining assignment!
Hair transplantation procedure.
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Progressive miniaturization of terminal hair is the hallmark of pattern hair loss. Miniaturization is a process in which large, pigmented terminal hair is replaced by fine colorless vellus hair, because of the shortening of the anagen phase in consecutive hair cycles. Pattern hair loss affects both males and females as progressive thinning of hair is a pattern that is different between males and females. Male pattern hair loss (MPHL) increases in frequency and incidence as age advances after puberty. MPHL is characterized by thinning of hair in the frontal, frontotemporal, and vertex areas of the scalp with variable loss of marginal, parietal, and occipital hair. Diagnosis is made clinically based on the history of hair thinning, hair loss, local examination, and a few simple tests. Anisotrichosis is finding on dermoscopy. The two main causative factors responsible are genetic predisposition and a derivative of testosterone, dihydrotestosterone (DHT). This is autosomal dominant and polygenic. The gene is X chromosome-linked indicating maternal component. Testosterone is converted by an enzyme 5-alpha reductase, into a more potent metabolite, Dihydrotestosterone, which is responsible for MPHL There are two types of 5- alpha-reductase, type one and type two. Finasteride is a competitive inhibitor of 5 α Reductase type II, while Dutasteride inhibits both alpha type I and type II. Finasteride and minoxidil are US-FDA approved as medical treatment of MPHL. The medical treatment is effective if started in the early phase of hair loss. . There are few side effects of finasteride, but the incidence is very low, and they are reversible once the finasteride is stopped. Medical treatment is not to treat the developed baldness. The treatment of baldness is the transplantation of hair follicles.
Do you loose more than 100 hair a day? It is not normal.praveenkumar509531
Hair grows everywhere on the human skin except on places like the palms of hands and the soles of feet, eyelids and belly buttons. Hair is made up of a protein called keratin that is produced in hair follicles in the outer layer of skin.
Biochemistry of Hair fall, A complete review of hair fall cause, Types, Current methods of treatment, Natural methods of treatment,
for more detail text see :https://iiopinion.blogspot.in/2017/01/hair-fall-scientific-way-of-treatment.html
alopecia hair loss Alopecia is a disease that causes hair loss.pptxittielarathi
Alopecia is a disease that causes hair loss. Most people lose hair on their scalp or beard area, but hair loss can occur anywhere on your body. A board-certified dermatologist can tell you if you have this type of hair loss and what may help you regrow your hair.
History plays the most important role in evaluating the process of alopecia.
Proper history along with the local and systemic examinations and investigations are needed to make the final diagnosis.
The decision to undertake a hair transplant shall be taken in the interest of the patient considering the patient’s requirements and short-term and long-term benefits.
A patient must understand that hair loss is an ongoing process. Hair transplant cannot prevent the loss of existing hair.
For coverage of the future balding area or to increase density, he/she may need more than one session of surgery.
A surgeon must refuse the patient if he/she has unrealistic goals or is not fit medically for the surgery or not satisfied with the technique of the hair transplant.
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NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
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Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
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Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
2. Causes of Hair loss
• Androgenetic alopecia (FPHL) is the most common cause of permanent hair
loss in women as it is in men.
Other common causes :
• Alopecia areata
• Telogen effluvium (acute /Chronic)- unusually accelerated hair loss that
may have hormonal, nutritional, drug-associated or stress-associated
causes.
• Traction alopecia- as may occur with tight braiding or corn-rowing of hair.
• Post traumatic- burns/ stitches scar
• Trichotillomania
• Loose Anagen syndrome
• Scarring Alopecia- Frontal fibrosing Alopecia
3. Indications of Hair transplant
• Female pattern hair loss is the most frequent indication for hair
transplant in women.
• Non-pattern indications are Traction Alopecia ,post traumatic hair
loss, high forehead.
4. Female pattern Hair loss
• FPHL is a gradual onset, slowly progressive nonscarring alopecia,
which can be seen any time after menarche, but is most common in
females after the age of 40 years.
• It results from a progressive reduction of Anagen phase in successive
hair cycle time leading to miniaturization of hair follicles.
• These changes are mediated through interaction between
androgens, their receptors and enzymes like 5a reductase and p450
aromatase.
5. Female Pattern Hair Loss (FPHL)
• Three different patterns of FPHL have been described.
1. Diffuse central thinning (Ludwig type)
2. Frontal accentuation (Olsen type)
3. Frontotemporal recession/vertex loss (male pattern/Hamilton type)
6. LUDWIG SCALE
• The diffuse hair loss is concentrated
over frontoparietal region leading to
thinning over central scalp with intact
frontal hair line .
• Ludwig graded it into three stages
depending upon whether the central
thinning is mild (stage I), moderate
(stage II), or severe, that is, near-
complete baldness of the crown (stage
III).
7. OLSEN SCALE
• Thinning and widening of the central part
of the scalp with breach of frontal
hairline, Chrismas-tree pattern.
8. Male pattern (Hamilton)
• It leads to recession of frontotemporal hairline
and/or thinning at vertex.
10. HISTORY
• Age of onset & progression
• Family History
• H/o diet pattern, weight loss, Iron deficiency anemia.
• Medical H/o Thyroid, AKT, Chemotherapy
• Enviromental factors like Smoking, Stress
• Gynaecological H/o- menstrual cycles, menopause, OCPs
11. GENERAL EXAMINATION
• Signs of Hyper androgenism like Hirsuitism, Acne, Acanthosis
nigricans
LOCAL EXAMINATION
• Presence of miniaturized/vellus hairs (short thin hairs <3 cm and a
shaft diameter of .03 mm) at the frontoparietal region
• Frontotemporal recession.
12. HAIR PULL TEST
• is usually negative.
• Shedding may or may not be present, and if present, is mild and
never profound as noticed in TE/CTE.
DERMOSCOPY
• Hair shaft diameter diversity(HDD) >20% has been reported to be an
early sign of female pattern hair loss.
• Peripilar halos and atrophy can also be seen during dermoscopy in a
few patients
13. HORMONAL SCREENING to rule out any underlying cause for
androgen excess
• free and total Testosterone
• DHEAS, LH, FSH
• T3, T4, TSH
• Prolactin
• Ultrasound for ovaries and adrenal glands
14. • SCALP BIOPSY reveals significant reduction of terminal to vellus hair
ratio. The T:V ratio is reduced from a normal of 8:1 to 3:1 in FPHL and
any ratio <4:1 is diagnostic of FPHL.
• Perifollicular infiltrate, fibroses, and follicular streamers may also be
seen.
• GLOBAL PHOTOGRAPHY
15. Medical Management
• Topical Minoxidil 2%
• Anti Androgens (cautious use in fertile age group)
Spironolactone 100-200mg
Finasteride 5mg
Flutamide
Oral Contraceptives
• Mutivitamins
• Ketoconazole shampoo
16. Hair Transplant in FPHL vs MPB
• Female pattern hair loss is less precisely defined compared to MPHL
& often difficult to differentiate from other entities such as CTE.
• Its multifactorial and many causes may coexist in same patient.
• FPHL is difficult to manage medically and future progression is
common.
• Underlying conditions such as PCOD, may ensure progression of the
disease.
• FPHL rarely causes total balding in localized area and causes diffuse
thinning.
17. • Individual Follicular units don’t disappear: Non uniform (1-2) hairs
within the unit decrease. making it technically difficult to plant grafts
between the hair.
• Shock loss is more common.
• Results are often more delayed
• Donor area is often not very gud.
• Trimming hairs in donor area is daunting for a woman.
18. Good Candidates
• Women having significant thinning
• Medical management has reached a plateau
• Compliant to continue medical treatment after Transplant
• Good donor area with long term potential
• Realistic expectations
• Post traumatic /Traction Alopecia
• Women with high hairline / wide forehead
19. Poor candidates
• Women with diffuse thinning including the Occipital area.
• Not compliant to Medical Treatment
• Unrealistic expectations
• Dysmorphophobia !
20. Counselling
• More then 1session of counselling
• Preferred hairstyle/ parting area
• Serial photographs
• Apprehensions about the pain
• Apprehensions about trimming the hair in Donor area
21. Shock Loss (Telogen effluvium)
• Post operative shock loss may happen 4-6 weeks after the procedure.
• The hair shedding is temporary and, they regrow around the same
time as transplanted hairs.
Before 3mo. Post op
22. Surgical planning
• Typical session is around 1500-2000 Grafts.
• Megasessions rarely required
• More tedious, so takes longer time
• Patience & precision are key
24. Technical tips
• Pre made slits/ stick & place
• Coronal slits/ sagittal slits
• Limited use of Adrenaline !
• Wetting the hairs & separating them by comb is helpful.
• Anterior hair line is made of 1-2 hair grafts, while 2-3 hair units are
used in back.
25. Coverage Planning
• In diffuse pattern of hair loss,
grafting has to be prioritized in the
parting area and in the central
forelock, behind the hairline.
*Dr Samuel Lam
26. Female Hair line
• The low-positioned (compared with men)
and rounded female hairline frames the
female face and adds youth, beauty, and
femininity to a woman’s face.
27. Female vs Male hair line
• The hairline should be rounded downwards at the fronto temporal
corners.
• Hairline is relatively straight and has fewer ‘sentinel hairs’ that
protrude out.
• The hairs rotate from a point centered typically just off of midline on
one side and cascade obliquely down the temple area, known as
‘cowlick’
• There can be ‘lateral mounds’ which are small protrusions of hairline
in the outer portion of the hairline
38. Camouflage
• The psychological impact of FPHL may also be reduced by cosmetic
products (Concealers) that improve the appearance of the hair.
• These agents work to minimize hair fibre breakage, improve hair
volume or conceal visible bald scalp.
• Scalp Micro Pigmentation (SMP)
